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Orthopaedic Proceedings
Vol. 105-B, Issue SUPP_16 | Pages 34 - 34
17 Nov 2023
Elliott M Rodrigues R Hamilton R Postans N Metcalfe A Jones R McGregor A Arvanitis T Holt C
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Abstract

Objectives

Biomechanics is an essential form of measurement in the understanding of the development and progression of osteoarthritis (OA). However, the number of participants in biomechanical studies are often small and there is limited ways to share or combine data from across institutions or studies. This is essential for applying modern machine learning methods, where large, complex datasets can be used to identify patterns in the data. Using these data-driven approaches, it could be possible to better predict the optimal interventions for patients at an early stage, potentially avoiding pain and inappropriate surgery or rehabilitation. In this project we developed a prototype database platform for combining and sharing biomechanics datasets. The database includes methods for importing and standardising data and associated variables, to create a seamless, searchable combined dataset of both healthy and knee OA biomechanics.

Methods

Data was curated through calls to members of the OATech Network+ (https://www.oatechnetwork.org/). The requirements were 3D motion capture data from previous studies that related to analysing the biomechanics of knee OA, including participants with OA at any stage of progression plus healthy controls. As a minimum we required kinematic data of the lower limbs, plus associated kinetic data (i.e. ground reaction forces). Any additional, complementary data such as EMG could also be provided. Relevant ethical approvals had to be in place that allowed re-use of the data for other research purposes. The datasets were uploaded to a University hosted cloud platform. The database platform was developed using Javascript and hosted on a Windows server, located and managed within the department.


Orthopaedic Proceedings
Vol. 105-B, Issue SUPP_8 | Pages 20 - 20
11 Apr 2023
Hamilton R Holt C Hamilton D Garcia A Graham C Jones R Shilabeer D Kuiper J Sparkes V Khot S Mason D
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Mechanical loading of joints with osteoarthritis (OA) results in pain-related functional impairment, altered joint mechanics and physiological nociceptor interactions leading to an experience of pain. However, the current tools to measure this are largely patient reported subjective impressions of a nociceptive impact. A direct measure of nociception may offer a more objective indicator. Specifically, movement-induced physiological responses to nociception may offer a useful way to monitor knee OA. In this study, we gathered preliminary data on healthy volunteers to analyse whether integrated biomechanical and physiological sensor datasets could display linked and quantifiable information to a nociceptive stimulus.

Following ethical approval, 15 healthy volunteers completed 5 movement and stationary activities in 2 conditions; a control setting and then repeated with an applied quantified thermal pain stimulus to their right knee. An inertial measurement unit (IMU) and an electromyography (EMG) lower body marker set were tested and integrated with ground reaction force (GRF) data collection. Galvanic skin response electrodes for skin temperature and conductivity and photoplethysmography (PPG) sensors were manually timestamped to the integrated system.

Pilot data showed EMG, GRF and IMU fluctuations within 0.5 seconds of each other in response to a thermal trigger. Preliminary analysis on the 15 participants tested has shown skin conductance, PPG, EMG, GRFs, joint angles and kinematics with varying increases and fluctuations during the thermal condition in comparison to the control condition.

Preliminary results suggest physiological and biomechanical data outputs can be linked and identified in response to a defined nociceptive stimulus. Study data is currently founded on healthy volunteers as a proof-of-concept. Further exploratory statistical and sensor readout pattern analysis, alongside early and late-stage OA patient data collection, can provide the information for potential development of wearable nociceptive sensors to measure disease progression and treatment effectiveness.


Orthopaedic Proceedings
Vol. 103-B, Issue SUPP_16 | Pages 64 - 64
1 Dec 2021
Hamilton R Holt C Hamilton D Jones R Shillabeer D Kuiper JH Sparkes V Mason D
Full Access

Abstract

Objectives

Current tools to measure pain are broadly subjective impressions of the impact of the nociceptive impulse felt by the patient. A direct measure of nociception may offer a more objective indicator. Specifically, movement-induced physiological responses to nociception may offer a useful way to monitor knee OA. In this proof-of-concept study, we evaluated whether integrated biomechanical and physiological sensor datasets could display linked and quantifiable information to a nociceptive stimulus.

Method

Following ethical approval, we applied a quantified thermal pain stimulus to a volunteer during stationary standing in a gait lab setting. An inertial measurement unit (IMU) and an electromyography (EMG) lower body marker set were tested and integrated with ground reaction force (GRF) data collection. Galvanic skin response electrodes and skin thermal sensors were manually timestamp linked to the integrated system.


Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_I | Pages 39 - 39
1 Jan 2011
Raman R Madhu T Hamilton R Shaw C Johnson G
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The aim of this study was to compare the clinical outcome, radiological outcome, activity level and functional outcome of hip resurfacing against metal on metal (MOM) hip arthroplasty.

Matched pairs of patients were selected from consecutive patients who had either MOM arthroplasty (n=236) or hip resurfacing (n=264). We matched 346 patients (173 pairs) in terms of age, sex, diagnosis, and a minimum follow up of 60 months. The functional outcome was assessed using Harris, Charnley-MDP, SF-36, UCLA and Tegner scores. Mean follow up was 67 months (61–80).

Mean age was 54.5 years. Femoral neck fractures were seen in 4 patients in the resurfacing group. The mean acetabular inclination was 42.8 deg and 44.3 deg in the resurfacing and MOM groups. Mean stem subsidence was 1.2mm. Bony ingrowth was seen in ninety six stems and all stems were stable by Engh s criterion. Radiolucent halo was observed around the stem of two resurfacing heads. The mean Harris hip score was 87.9 and 88.2 in the MOM and resurfacing groups respectively (p=0.76). The SF 36 score was 77.8 and 80.1 (p=0.4). The UCLA and Tegner scores were 6.1 and 3.6 for the resurfacing group and 5.9 and 3.9 for the MOM group. Nine patients in the resurfacing group had a postoperative painful limp which settled by 3 months. There was no radiological evidence of implant failure at last follow up. Survival at 5 years was 100% for the MOM group and 94.1% for the resurfacing group.

Functional outcome and activity levels increased in both groups with no difference between the groups. Post operative complications were fewer in MOM group and return to activity was quicker. It appears that resurfacing arthroplasty offers no medium term advantages over MOM arthroplasty. However longer follow up is required to establish the longevity and durability of this implant.


Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_II | Pages 400 - 400
1 Jul 2008
McNair CJ Hamilton R Boddie DE Kelly I
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Aim: To review the prognosis of Pelvic Osteosarcoma in the files of the Scottish Bone Tumour Registry between 1955 and 2001.

Text: The cases of 40 consecutive patients with osteosarcoma of the pelvic ossea registered in the files of the Scottish Bone Tumour Registry between 1955 and 2001 were reviewed. 6 of these patients had underlying Paget’s disease and 2 had received previous radiotherapy to the pelvis. The median age at diagnosis was 60 years (mean 55.7 years). 12 patients had distant metastases at initial presentation (Enneking stage III). 24 patients had stage IIB ostesarcomas, 3 patients had stage IIA osteosarcomas and 1 patient had stage IB osteosarcoma. The median survival of stage IIB and stage III ostesarcoma was 9.5 months (1–39 months) and 5.5 months (0.5–16 months) respectively. The median age of survival for stage IIB tumours treated prior to the introduction of chemotherapy was 9 months (1–30 months) compared to those whose treatment included chemotherapy of 12 months (4–39 months). 5 of the 40 patients treatment regimens included surgical intervention- all had stage IIB tumours. The median survival for this group was 13 months (4–39 months).

Conclusion: Despite the introduction of modern multimodality treatment regimens the prognosis for pelvic osteosarcoma remains poor.